OP04.34: Assessment of the fetal myocardial performance by tissue Doppler imaging

Abstract

The myocardial performance index (MPI) determined by conventional pulsed Doppler method is a simple non-invasive measurement for assessing global ventricular function. Recently the MPI has shown promise in the analysis of ventricular function in fetuses, children and adults with various heart diseases. This index can also be obtained by PW-Tissue Doppler Imaging (PW-TDI). Color Tissue Doppler Imaging (C-TDI) is a new tool in adult cardiology. It represents a novel approach to fetal cardiac imaging. Until now there is no experience with C-TDI for the assessment of a fetal MPI. In the present study, we analysed 180 data files of 20 normal fetuses (20.0–25.0 week of gestation). After a echocardiographic examination, high-frame rate (> 100/sec) TDI data of an apical four chamber view was recorded with a Toshiba Aplio 80 research ultrasound system. At least 3 consecutive fetal cardiac cycles were stored digitally. Velocities were measured offline with TDIQ-software by placement of 8 ROI (RA; LA; RV, LV and Septum annular; RV, LV and Septum basal). A fetal heart cycle was identified and measured reproducible. The anunular and ventricular measurements allowed the evaluation of the following systolic and diastolic velocity parameters: IVC; systole (ejection); IVR; E′- and A′-wave. Based on this data the calculation of the MPI and other current performance parameters, e. g. IVA and E/A ratio, was possible by the use of C-TDI. The calculated fetal MPI values correspond to published data of PW and PW-TDI studies. Measurements of the fetal MPI by C-TDI is easy to obtain. For the first time C-TDI allows the comparison of biventricular performance parameters in the same fetal cardiac cycle. Therefore it is a promising new tool for the assessment of fetal heart function.